Quality statement 5: Antibiotic treatment for asymptomatic adults with catheters and non‑pregnant women

Quality statement

Healthcare professionals do not prescribe antibiotics to treat asymptomatic bacteriuria in adults with catheters and non‑pregnant women.

Rationale

Antibiotics are not effective for treating asymptomatic bacteriuria in adults with catheters or non‑pregnant women. Unnecessary treatment with antibiotics can also increase the resistance of bacteria that cause urinary tract infections, making antibiotics less effective for future use.

Quality measures

Structure

a) Evidence of local arrangements to ensure healthcare professionals do not prescribe antibiotics to treat asymptomatic bacteriuria in adults with catheters and non‑pregnant women.

Data source: Local data collection.

b) Evidence of local arrangements to ensure healthcare professionals do not prescribe antibiotics to treat asymptomatic bacteriuria in adults with catheters and non‑pregnant women.

Data source: Local data collection.

Process

a) Proportion of episodes of asymptomatic bacteriuria in adults with catheters treated with antibiotics.

Numerator – the number in the denominator treated with antibiotics.

Denominator – the number of episodes of asymptomatic bacteriuria in adults with a catheter.

Data source: Local data collection.

b) Proportion of episodes of asymptomatic bacteriuria in non‑pregnant women treated with antibiotics.

Numerator – the number in the denominator treated with antibiotics.

Denominator – the number of episodes of asymptomatic bacteriuria in non‑pregnant women.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as hospitals, community services, care homes, GPs) ensure that processes are in place so that healthcare professionals do not prescribe antibiotics to treat asymptomatic bacteriuria in adults with catheters and non‑pregnant women. Internal training and education may be required, according to local need.

Healthcare professionals ensure that antibiotics are not prescribed to treat asymptomatic bacteriuria in adults with catheters and non‑pregnant women.

Commissioners (such as clinical commissioning groups, local authorities and NHS England area teams) ensure that providers are aware that antibiotic treatment should not be prescribed to treat asymptomatic bacteriuria in adults with catheters and non‑pregnant women. This could be included in local service specifications and pathways.

What the quality statement means for patients, service users and carers

Adults with catheters and non‑pregnant women who have bacteria in their urine but no symptoms of urinary tract infection are not prescribed antibiotics.

Source guidance

Definitions of terms used in this quality statement

Asymptomatic bacteriuria

Bacteria in a urine sample taken from a person who does not have any of the typical symptoms of lower or upper urinary tract infection. Asymptomatic bacteriuria should be confirmed by 2 consecutive urine samples (Management of suspected bacterial urinary tract infection in adults. Scottish Intercollegiate Guidelines Network [2012]).